Sleep and Aging - Yale Medicine Explains

Transcript

• 00:00- My name is Brienne Miner, and I'm assistant professor
• 00:03at Yale University in the section of geriatrics.
• 00:05I've also done training in sleep medicine.
• 00:08And today, I'm gonna talk about sleep and aging
• 00:11and I'm gonna cover the different ways
• 00:13that sleep might change as we age,
• 00:15all of the different factors
• 00:17that might be causing sleep problems as we get older,
• 00:20and when you should speak with your doctor
• 00:22about a sleep problem.
• 00:26Most people think that as you get older you need less sleep.
• 00:30But if we look at how much sleep is recommended,
• 00:34it really doesn't change from middle to older age.
• 00:37So middle-aged adults,
• 00:39according to the National Sleep Foundation,
• 00:41should be getting, the real sort of sweet spot
• 00:44is seven to nine hours.
• 00:46And in adults 65 and older it's seven to eight hours.
• 00:50So you know, we do recognize that a little bit
• 00:53on either side, so five hours or up to nine hours
• 00:56may be appropriate.
• 00:57But I think the interesting thing is that
• 01:00if you compare middle-aged and older age adults,
• 01:03the recommendation for how much sleep you should be getting
• 01:05is the same.
• 01:09As we get older, there are probably multiple things going on
• 01:14at the same time that might impact our sleep.
• 01:16So I like to think about what medical conditions
• 01:20or medications a patient of mine might be taking
• 01:22and how that might affect their sleep.
• 01:24Medical conditions could certainly cause pain
• 01:27or other sleep disruptive symptoms.
• 01:29People can be on medications
• 01:31that could make them very sleepy during the day.
• 01:35Those medications could make it hard for them
• 01:37to sleep at night.
• 01:38Or interestingly, those medications might cause
• 01:42or worsen an underlying sleep disorder.
• 01:44In terms of behavioral factors,
• 01:47we like to think about having good sleep hygiene,
• 01:50having good behaviors around sleeping.
• 01:53And so those are basic things like going to bed
• 01:55at the same time every night,
• 01:57getting up at the same time every morning,
• 02:00avoiding napping during the day,
• 02:02especially if you have trouble sleeping at night,
• 02:04and a big one that I like to touch on
• 02:06is what substances might contribute to sleep.
• 02:09So alcohol, especially as you get older,
• 02:13can cause more problems with sleep
• 02:16because your body is not as good at metabolizing alcohol
• 02:19as you get older, and you can't drink the same amount
• 02:24in your older age that you could in your middle age.
• 02:26Caffeine, same story as alcohol, and nicotine as well
• 02:30can make it hard to fall asleep,
• 02:32can make it hard to stay asleep.
• 02:34Other things like being socially isolated,
• 02:38I think we've all been thinking a lot about that
• 02:39especially in the setting of COVID.
• 02:42So why does social isolation cause problems with sleep?
• 02:45Well, you're less physically active during the day
• 02:49and that can make it harder
• 02:50to have a normal sleep/wake schedule.
• 02:53And those social interactions are actually also
• 02:56very important for giving cues to our body
• 02:59to help help us maintain a normal sleep/wake rhythm.
• 03:01And then I would be remiss if I didn't mention what we think
• 03:04about a lot in sleep medicine, which is that almost all
• 03:07of the sleep disorders that are out there
• 03:10become more common as we age.
• 03:12So people in their older age could have
• 03:15multiple things going on at the same time.
• 03:19One of the major changes that's normal
• 03:22and is not necessarily a sign of disease
• 03:25is that many older people prefer to go to bed earlier
• 03:29and wake up earlier.
• 03:31So as opposed to going to bed at maybe say 10 or 11 o'clock,
• 03:34some people may have a preference to go to bed at seven
• 03:38or 8:00 PM, and that's because there's a a change
• 03:42in the timing of melatonin release from our brain.
• 03:45So melatonin is sort of setting that time for us.
• 03:50And in many older people, our brain releases melatonin
• 03:53in an earlier time.
• 03:55So again, it's not necessarily a problem
• 04:00except that many people don't like to go to bed at 7:00 PM
• 04:04or wake up at three or four o'clock in the morning.
• 04:08So I would say, if your preference is to go to bed
• 04:11at 8:00 PM, there's no problem with that.
• 04:15But you wouldn't want to, or it would be normal then
• 04:19to wake up at three or four o'clock in the morning.
• 04:22That's still a normal amount of sleep.
• 04:24So there's actually no problem with that
• 04:25unless it's a problem for your schedule.
• 04:30So some important takeaways about sleep as we age,
• 04:34are first that the timing of sleep may change.
• 04:37So older adults may find that they have a preference
• 04:40to go to bed earlier and therefore wake up earlier.
• 04:45The amount of interruptions or arousals from sleep
• 04:49become more frequent as we get older.
• 04:51But as long as they're brief and you're able
• 04:53to get back to sleep, that's not a problem.
• 04:55And then finally, I would say there could be
• 04:57a lot of things contributing to sleep problems in older age,
• 05:02but I look at that as a glass half full kind of person.
• 05:05When somebody comes to me with a sleep problem,
• 05:07I think there are a lot of things we could do to help sleep,
• 05:10whether it has to do with medical conditions, medications,
• 05:15behaviors or treating an underlying sleep disorder.
• 05:18So I think that's an important takeaway.
• 05:20If you do have a sleep problem,
• 05:22you should talk to your doctor,
• 05:24you should get an evaluation, and there might be
• 05:26a lot of options for you that don't necessarily mean
• 05:28having to take another medication.